The following is excerpted from a press release MSF issued on February 18, 2014.

The extreme levels of violence against civilians and targeted killing of minority groups in CAR illustrates the utter failure of international efforts to protect the population. MSF calls on member states of the UN Security Council, as well as donor countries, to mobilize to immediately halt the atrocities against the population; establish the level of safety needed for people to move freely without fear for their lives; and organize a massive deployment of aid to meet the basic needs of the population. Local and national leaders must do their utmost to stop the violence and enhance protection.

“We are caught in a sense of helplessness faced with extreme violence, treating thousands of wounded, and seeing hundreds of thousands of people fleeing their homes as it is their only option to avoid being slaughtered,” said Dr. Joanne Liu, MSF international president, who recently returned from CAR. “There is a shocking lack of engagement and mobilization of political leaders in the UN Security Council, and a too-limited one from African countries and the African Union to address the violence that is literally tearing apart the Central African Republic.”

Central African civilians of both of the main religious communities are being held hostage to violence instigated by armed groups who bear primary responsibility for the atrocities. Since December 5, MSF teams have treated over 3,600 wounded in the capital and around the country. This includes gunshot, grenade, machete, knife, and other violent trauma.

“When I was in Bozoum, we found 17 injured people with wounds from gunshots, machetes, and a grenade, hiding in a small courtyard,” said Dr. Liu. “They were too scared to go to the hospital in case they were targeted again.”

MSF teams are constantly dealing with violent attacks taking place in close proximity to or inside hospitals. For instance on February 12 in Berberati town, men armed with machetes and guns entered the hospital where MSF is working, firing shots and threatening patients. On countless other occasions in various locations, local leaders, religious clerics, and MSF medical staff have had to physically intervene in situations in which armed men were attacking or threatening to kill individuals, including sick and wounded patients.

In eight places where MSF works, some 15,000 civilians are gathered and trapped in hospitals, churches, or mosques, living in fear of being killed by armed groups. MSF has opened health posts in many of these enclaves, including in Bangui, as people are too fearful to go to the hospital even if it is only a few hundred meters away.

Over the past two weeks, MSF teams have seen tens of thousands of people from the Muslim community in Bangui, Baoro, Berberati, Bocaranga, Bossangoa, Bouca, Bozoum, and Carnot fleeing or being trucked away to neighboring countries by international armed forces that were, otherwise, incapable of protecting them. Others have been evacuated from the northwest of the country to Bangui and are now trapped in enclaves and camps where they continue to live in terror. Fear of persecution has pushed tens of thousands of civilians from all communities to flee to the bush, without access to any form of protection or humanitarian assistance.

The devastating toll has been further compounded by the lack of a meaningful scale-up of humanitarian assistance to meet even the most basic needs of the people. Assistance has been appalling in Bangui and practically nonexistent outside the capital.

Even though security incidents hamper MSF’s operations on a daily basis, the extensive deployment of MSF staff—more than 2,240 international and national staff—and activities in 16 towns around the country shows it is feasible to provide humanitarian assistance.

“This is a massive catastrophe unfolding in full view of international leaders,” said Dr Liu. “To not respond is a conscious and deliberate choice to abandon the people of the Central African Republic.”